Researchers at MUHC/McGill and colleagues at UCSF have evaluated the effectiveness of HIV treatment in patients who enter and leave prison
HIV/Aids is up to five times more prevalent in American prisons than in the general population. Adherence to treatment programs can be strictly monitored in prison. However, once prisoners are released, medical monitoring becomes problematic. A new study by Dr. Nitika Pant Pai - an Assistant professor of Medicine and a medical scientist at the Research Institute of the MUHC - suggests the majority (76%) of inmates take their antiretroviral treatment (ART) intermittently once they leave prison, representing a higher risk to the general population.
"Over a period of 9 years, we studied 512 HIV positive repeat offender inmates from the San Francisco County jail system," says Dr. Pant Pai. "Our results show that only 15% continuously took their ART between incarcerations or after their release." According to the study, published in the journal PLoS one, these figures highlight a lack of effectiveness on the part of medical monitoring services for these people outside prison.
"Taking ART intermittently is a problem because it depletes the CD4 count - the immunizing cells that fight infection - and increases the probability of developing resistance to the virus," says Dr. Pant Pai. "The risk for rapid disease progression becomes higher and presents a risk for public health transmission of HIV to their partners." According to the study those on intermittent therapy were 1.5 times more likely to have higher virus load than those on continuous therapy; those who never received therapy were 3 times more likely to have a higher VL.